PloS one · 2026
Mortality amongst European children with congenital anomalies: Associations with socio-economic status in the EUROLINKCAT cohort.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Jordan Sue, Tucker David, Scanlon Ieuan, Thayer Daniel S, Ballardini Elisa, Cavero-Carbonell Clara, Damkjaer Mads, Gatt Miriam, Gissler Mika, Ostapchuk Lyubov, Santoro Michel, Stevens Sarah, Wellesley Diana, Wertelecki Wladimir, Given Joanne, Loane Maria, Evans Hywel T
Аннотация
BACKGROUND: Childhood mortality is affected by major congenital anomalies and socio-economic status (SES). To our knowledge, their combined impact has not been explored to age 10.
METHODS: We analysed the population-based EUROlinkCAT cohort to ascertain the impact of SES on mortality by ages 1 and 10 amongst children with congenital anomalies in ten congenital anomaly registers in seven European countries. Four countries defined SES according to maternal education, and two used their national index of multiple deprivation. The ten registers used a common script to generate data on survival by ages 1 and 1-10 (365-3651 days). Eight registers analysed deaths according to their SES criteria, categorised as low, intermediate and high SES. Linked data were combined in random effects meta-analyses. Finland and Emilia-Romagna held data on single motherhood and EU-nationality.
RESULTS: We analysed mortality in relation to SES using data on 47,134 live-born children with major congenital anomalies classified and recorded 1996-2014. Mortality by age 1 and ages 1-10 was higher amongst the most than the least deprived, hazard ratios (HR) and 95% confidence intervals (CI) 1.47, 1.19-1.83 and 2.00, 1.32-3.02. Differences between intermediate and least deprived groups were smaller. Differences were statistically significant for all four analyses only in Ukraine and Wales. Mortality rates were higher for children of non-EU nationals, but not single mothers.
IMPLICATIONS: Deprivation was more strongly associated with death at ages 1-10 than in infancy. These analyses of the most ill children in Europe indicate that, to achieve sustainable development goals, more resources are needed for the most vulnerable children.
METHODS: We analysed the population-based EUROlinkCAT cohort to ascertain the impact of SES on mortality by ages 1 and 10 amongst children with congenital anomalies in ten congenital anomaly registers in seven European countries. Four countries defined SES according to maternal education, and two used their national index of multiple deprivation. The ten registers used a common script to generate data on survival by ages 1 and 1-10 (365-3651 days). Eight registers analysed deaths according to their SES criteria, categorised as low, intermediate and high SES. Linked data were combined in random effects meta-analyses. Finland and Emilia-Romagna held data on single motherhood and EU-nationality.
RESULTS: We analysed mortality in relation to SES using data on 47,134 live-born children with major congenital anomalies classified and recorded 1996-2014. Mortality by age 1 and ages 1-10 was higher amongst the most than the least deprived, hazard ratios (HR) and 95% confidence intervals (CI) 1.47, 1.19-1.83 and 2.00, 1.32-3.02. Differences between intermediate and least deprived groups were smaller. Differences were statistically significant for all four analyses only in Ukraine and Wales. Mortality rates were higher for children of non-EU nationals, but not single mothers.
IMPLICATIONS: Deprivation was more strongly associated with death at ages 1-10 than in infancy. These analyses of the most ill children in Europe indicate that, to achieve sustainable development goals, more resources are needed for the most vulnerable children.